PreBolusing Time as a Measure of Basal Strength

Type 1 & LADA New T1/LADA
1

I’m always looking for additional indicators that will help me adjust my temp basal needs accurately and timely for my changing insulin sensitivity. (I use Humalog in my pods.)

I’m currently watching how long it takes my boluses to start working (prebolusing for meals or just correction boluses in general) as an indicator of how well my basal rate is matched to my insulin needs. It seems that if my boluses start working in 10 minutes or less, my basal is too high for the scenario. If my boluses start working in 10 - 20 minutes, my basal is probably well matched. If my boluses take much longer than 20 minutes to work, I’m probably not using enough basal for my current insulin sensitivity or activity levels.

Thoughts?

2

I don’t agree with that. Maybe it’s a matter of perspective.

I would say this:

It seems that if my boluses start working in 10 minutes or less, my basal is too high for the scenario. that’s exactly what I want! If I drop too low when I am not eating, then my basal is too high…

Again, just a matter of a different perspective I think.

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3

I think it depends on what I’m trying to accomplish.

What I am going for on a daily basis is gentle bg trends in both directions. If I am taking so much basal that my boluses work in 10 minutes or less, I run into two main problems that lend themselves to pin-balling (for me):

  1. My boluses are harder to get right bc if they work that fast, I don’t need nearly as much, and I either tank from too much bolus or I way under-dose and spike.
  2. My basal is set too strong and will drop me pretty fast if my activity level changes very much at all…which I don’t care for.

For me, my boluses should take between 10-20 minutes on a work day…less on a weekend day…and maybe that is where we differ.

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4

How about using an extended bolus then?

5

I do. Anything over 3.5 units I extend over half an hour.

6

@Eric, despite different technique on timing goals, it sounds like you do think this could be another indicator of basal effectiveness?

7

Absolutely! Yes, I certainly believe it can be an indicator.
(A partial indicator at least. There are other things to consider, of course)

I think the only difference we have is what we believe to be “too much” basal versus “just right”. I like the bolus that works right away! That’s how I get away with a lot of the crap I pull at the table.

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